EP2866679A1

EP2866679A1 - Apparatus and method for delivering surgical tissue connectors into an abdominal cavity and removing the surgical tissue connectors from the abdominal cavity

Info

Publication number: EP2866679A1
Application number: EP13809773.8A
Authority: EP
Inventors: Jeffrey Smith; Darren R. Sherman
Original assignee: Freehold Surgical LLC
Current assignee: Freehold Surgical LLC
Priority date: 2012-06-29
Filing date: 2013-06-26
Publication date: 2015-05-06
Anticipated expiration: 2033-06-26
Also published as: CA2877865C; CN104540456B; AU2017203467A1; JP6328302B2; US20150201934A1; US9855044B2; JP6148337B2; CA2877865A1; IN2015DN00690A; US20180116666A1; CN104540456A; JP2015522343A; JP6553243B2; EP2866679B1; EP2866679A4; WO2014004654A1; JP2018134460A; JP2017176854A; US20200375599A1; US10743878B2

Abstract

[0001] The present invention is directed to an apparatus and its method of use in delivering surgical tissue connectors into an area of the body and removing the surgical tissue connectors from the body area. Svlore specifically, the present invention is directed to a surgical tissue connector apparatus having at least two tissue connectors connected by a length of cord and a delivery and removai tube. At least one of the tissue connectors has a base with a tapered, beveled or chamfered surface projecting from one end of the base. A hook or other type of tissue connector projects from the opposite side of the base. The hook is positioned on the base where a peripheral side surface of the base shields the hook from unintentionally snagging objects. The base peripheral surface is also dimensioned to slide easily through an interior bore of the tube. This enables the base and the projecting hook to be easily delivered through the tube into an area of the body. The chamfered or tapered surface on the base is positioned to engage with the distal end opening of the tube and direct the base into the center of the tube as the surgical tissue connector is retracted info the tube from the body area in removing the apparatus from the abdominal cavity.

Description

APPARATUS AND METHOD FOR DELIVERING SURGICAL TISSUE CONNECTORS INTO AN ABDOMINAL CAVITY AND REMOVING THE SURGICAL TISSUE CONNECTORS FROM THE ABDOMINAL CAVITY

BACKGROUND OF THE INVENTION FIELD OF THE INVENTION

[0001] The present invention is directed to an apparatus and its method of use in delivering surgical tissue connectors into an area of the body and removing the surgical tissue connectors from the body area. Svlore specifically, the present invention is directed to a surgical tissue connector apparatus having at least two tissue connectors connected by a length of cord and a delivery and removai tube. At least one of the tissue connectors has a base with a tapered, beveled or chamfered surface projecting from one end of the base. A hook or other type of tissue connector projects from the opposite side of the base. The hook is positioned on the base where a peripheral side surface of the base shields the hook from unintentionally snagging objects. The base peripheral surface is also dimensioned to slide easily through an interior bore of the tube. This enables the base and the projecting hook to be easily delivered through the tube into an area of the body. The chamfered or tapered surface on the base is positioned to engage with the distal end opening of the tube and direct the base into the center of the tube as the surgical tissue connector is retracted into the tube from the body area in removing the apparatus from the abdominal cavity. DESCRIPTION OF THE RELATED ART

[0002] in laparoscopic surgery procedures, it is often necessary to pass surgical tissue connectors though a cannula, trocar, endosope or other similar device thai is positioned through an incision in th body to deliver the tissue connectors into an area of the body where the connectors are used in a laparoscopic surgery procedure. A disadvantage associated with the current constructions of surgical tissue connectors and the tubular delivery device used to deliver the connectors info the body and then remove the connectors from the body is that often the connectors wiil snag or catch a portion of the tubular delivery device being used to deliver or retrieve the connectors.

SUMMARY OF THE INVENTION

[00033 The present invention overcomes the above described disadvantages associated wit tissue connectors used in laparoscopic and other surgery procedures by providing an apparatus that facilitates the delivery of a surgical tissue connector through a tubular delivery device and into the body, and the subsequent removal of the surgica! tissue connector through the tubular device from the body.

[0004] The basic construction of the apparatus of the invention includes at least two surgical tissue connectors. Each tissue connector has a base. The base has a side surface that extends around the base, and a distai end surface and proximai end surface at the opposite ends of the side surface, in one embodiment of the tissue connector, the base side surface is a cylindrical surface having a center axis that defines mutually perpendicular axial and radial directions relative to the base. [000δ]Α hook is secured stationary to and projects axially from the base distal end surface. The hook has a shank portion that extends axially from the base distal end surface. The shank portion is substantially parallel with the base center axis but spaced radially from the center axis. The hook also has a bent portion that extends from the shank portion across the base distal end surface and through the center axis to a distal end tip of the hook. The end tip and the shank are radially spaced on opposite sides of the base center axis and the end tip does not project radially beyond the base side surface, Thereby, the base side surface shields the end tip of the hook from snagging or catching with other objects.

[0006] The base proximal end surfac of at least one of the connectors has a chamfered or tapered configuration that tapers as the proximal end surface extends axially away from the base side surface. In one embodiment of the apparatus, the base proximal end surface has a conical configuration. The conical configuration of the base proximal end surface extends axially from the base side surface to an apex that is centered on the base distal end surface.

[00073 The apparatus also includes a length of cord that extends between the proximal end surfaces of the tissue connectors, in one embodiment of the apparatus, the length of the cord extending between the tissue connectors is flexible and can be adjusted.

[0008] The apparatus also includes a tissue connector delivery and removal tube. In one embodiment of the apparatus, the tube has a straight length with opposite proximal and distal ends, and a cylindrical interior bore that extends through the length of the tube. The interior bore has an interior diameter dimension that is slightly larger than an exterior diameter dimension of the base cylindrical side surface. This enables the tissue connectors to easily slide through the interior bore of the tube when delivering the tissue connectors through the tube, or removing the tissue connector through the tube. Additionally, the tapered configuration of the base proximal end surface of at least one of the tissue connectors enables that tissue connector to be easily pulled into the tube at the tube distal end. Removing the apparatus by pulling the other tissue connector through the tube distal end and then puliing the cord and the tapered tissue connector into the tube causes the tapered configuration of the base proximal end surface to first enter the end of the tube, whereby the tapered configuration centers the base cylindrical side surface relative to the tube interior bore as the tapered proximal end surface is pulled into the tube interior bore. With the base side surface centered in the tube interior bore, the hook projecting from the base distai end surface is prevented from snagging or catching the distal end of the tube as the tissue connector is pulled into and through the tube,

[0009] The apparatus also includes a rod having a straight length that is dimensioned to be inserted into the tube proximal end to push the tissue connectors and their connecting cord through the tube interior bore to deliver the tissue connectors and the connecting cord from the tube distal end,

[0010] When use of the apparatus in the surgical procedure is complete, the apparatus can be easily removed from the body by inserting the tube through a cannula, or an incision to position the tube distal end adjacent the connectors and the cord, and then inserting a surgical grasper through the tube and grasping the tissue connector without the tapered end surface. The tissue connector is grasped at its hook. Retracting the grasper back through the tube will move the grasped connector into the tube and then puii the cord into the tube inferior bore. As the cord is pulled through the tube bore it pui!s the tapered proximal end surfaces of the other tissue connectors into the bore. The tapered proxima! end surface of the connector will center the connector and the cylindrical side surface of the connector relative to the interior bore as the connector enters the tube distal end and passes through the interior bore. The cylindrical side surface of the connector prevents the hook extending from the distal end surface of the connector from snagging or catching against the tube distal end as the connector enters into and passes through the tube interior bore.

[0011 ] As described above, the apparatus of the invention and its method of use facilitate the delivery of surgical tissue connectors to a surgery site and facilitate the removal of the surgical tissue connectors from the surgery site.

DESCRIPTION OF THE DRAWINGS

[0012] Further features of the apparatus of the invention and its method of use are set forth in the following detailed description of the apparatus and method and are shown in the drawing figures.

[0013] Figures la and lb show an embodiment of the apparatus comprising a pair of tissue connectors connected by a cord where one of the tissue connectors employs a releasabSe one-way cord lock that enables adjusting the length of the portion of the cord extending between the pair of tissue connectors. [0014] Figures 2a and 2b show further embodsments of the apparatus similar to tha of Figures 1a and 1b.

[0015] Figure 3 is a perspective view of one of the tissue connectors.

[0016] Figure 4 is a plan view of the tissue connector of Figure 3.

[0017] Figures 5a and 5b illustrate the assembly of the tissue connector of Figure 3.

[0018] Figure 8 is a perspective view of a further embodiment of a tissue connector.

[0019] Figure 7 is a pian view of the tissue connector of Figure 6.

[0020] Figures 8a and 8b illustrate the assembly of the tissue connector of Figure 6.

[0021] Figure 9 is a perspective view of a further embodiment of a tissue connector.

[0022] Figure 10 is a side view of the tissue connector of Figure 9,

[0023] Figure 1 is a cross-section view of the tissue connector of Figure 9.

[0024] Figure 12 is a perspective view of the disassembled component parts of the tissue connector of Figure 9.

[002S] Figure 13 is a cross-section view of the delivery and removal tube of the apparatus.

[0026] Figure 14 is an end view of the proxsmaf end of the delivery and removai tube. 0027] Figure 15 is a side view of the delivery rod of the apparatus. [0028] Figure 18 is a partial sectioned view of the apparatus illustrating the method of removing a tissue connector of the apparatus from an abdominal cavity using the delivery and removal tube of the apparatus.

[0029] Figure 17 is a partial sectioned view of the apparatus further illustrating the method of removing a tissue connector of the apparatus from an abdominal cavity using the delivery and removal tube of the apparatus.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0030] Figs. 1A and 1B show an embodiment of the tissue connector apparatus of the invention that is constructed to facilitate the delivery of the tissue connectors through a cannula or other type of tubular delivery device to a surgical site of a body for use in a laparoscopic surgery or other typ of surgical procedure, and facilitate the removal of the tissue connectors of the apparatus following completion of the procedure. As is conventional with laparoscopic apparatus, the component parts of the apparatus are dimensioned to be inserted through an incision or through a cannula, trocar, endoscope or other type of tubular delivery device extending into the body to position the apparatus at a surgery site. All of the component parts of the apparatus to be described are constructed of biocompatible materials.

[0031 ] The first embodiment of the apparatus is shown in Figs. 1a and lb. The embodiment shown is basically comprised of a first tissue connector 12, a second tissue connector 14 and a length of cord 18 extending between and connecting the two tissue connectors. The cord could be a suture, IV tubing or other equivalent types of cord and could be one piece or several pieces connected together. [00.32] Details of the construction of the first tissue connector 12 are shown in Figs. 3, 4, 5a and 5b. The first tissue connector 12 is comprised of a base 18 and a hook 22. The base 18 for the most part is a soiid single piece of material having a side exterior surface that extends completely around the base, in the embodiment shown in the drawing figures, the side surface 24 is cylindricai. The cylindrical surface 24 has a center axis 26 that defines mutually perpendicular axial and radial directions relative to the base. The base a!so has a proximal end surface 28 at one axial end of the base and a distal end surface 30 at an opposite axial end of the base.

[0033] The proximal end surface 28 is chamfered or tapers as it extends axiaily away from the base side surface 24. In the embodiment shown, the proximal end surface 28 has a conical configuration with a circular peripheral edge 32 defined by the intersection of the proxsma! end surface with the cylindrical base side surface 24. The proximal end surface 28 tapers as it extends axiaily from the base side surface 24 to an apex end 34 of the proximal end surface.

[0034] The base distal end surface 30 is substantially flat. The dsstal end surface 30 has a circular peripheral edge 36 defined by the intersection of the distal end surface with the cylindrical base side surface 24.

[0035] A hook hoie 38 is formed in the base distal end surface 30. The hook hole 38 is spaced radially inwardly from the distal end surface peripheral edge 36 and radially from the center axis 28. The hook hole extends axiaily into the base a short distance from the distal end surface 30 and does not extend entirely through the base. A center hoie 42 is also formed in the base at the center of the base distal end surface 30. The center hole 42 extends axiaily through the base and emerges at the apex 34 of the base proximal end surface 28. The center hole 42 has a slightly larger interior diameter dimension adjacent the base distal end surface 30 than the interior diameter dimension of the hole 42 adjacent the apex 34 of the base proximal end surface 28.

[0036] The hook 22 has a straight shank portion 44 extending from a proximal end 46 of the hook. The hook shank portion adjacent the hook proximal end 46 is dimensioned with a cylindrical exterior surface that fits tightly into the hook hole 38 in the base distal end surface 30. The hook shank portion 34 is secured stationary to the base by laser welding or other equivalent means. The hook 22 is secured to the base distal end surface 32 with the hook shank portion 34 extending axia!ly from the distal end surface 32 substantially parallel with the center axis 28, but radiaily spaced from the center axis. The hook shank portion 44 extending from the distal end surface 30 has a square or other similar cross-section configuration to facilitate grasping the hook with a surgical grasper and preventing the hook shank from rotating in the grasper. The shank portion 44 extends axially from the base distal end surface 30 to a bent portion 48 of the hook that extends radially across the distal end surface 3G, through the base center axis 26 and to a distal end tip 52 of the hook. The distal end tip 52 and shank portion 44 of the hook are each radiaily spaced on opposite sides of the base center axis. The shank portion 44 and end tip 52 are both spaced a radiai distance dimension on opposite sides of the center axis 26 that is smaller than the base radius dimensioti, whereb the hook bent portion and tip do not project radially beyond the cylindrical side surface of the base. Although the hook 22 is shown as the part of the tissue connector 12 that is removably aitachabie to body tissue, other equivalent devices that do not project radia!ly beyond the side surface of the base could be used.

[0037] In the embodiment of the apparatus shown in Figs. 1a and 1b, the cord 16 has a flexible iength with opposite first 54 and second 56 ends. The cord first end 54 passes throug the center hole 42 of the first tissue connector 12 from the proximal end surface 28 to the distal end surface 30. A knot 58 is tied in the cord first end 54. A medical grade glue, for example cyanoacryiate is applied to the knot. The cord is pulled from the base proximal end surface 28 to pui! the knot 58 into the center hole 42 in the base distal end surface 30. The knot 56 is too large to pass though the smaller portion of the center hole 42 that emerges from the apex 34 of the proximal end surface 28. Thereby, the cord first end 54 is secured to the first tissue connector 12 with the cord extending from the base proximal end surface 28 of the tissue connector.

[0038] Figs. 6, 7, 8a and 8b show an alternate embodiment of the first tissue connector where a post 62 of an eyelet ring 64 is inserted through the base center hole 42 from the base proximal end surface 28. The post 62 is secured to the base by laser welding the end of the post 62 in the center hole at the base distal end surface 32. The eyelet ring 64 could be secured to the base by other equivalent means. The first end 54 of the cord 16 is then secured to the eyelet 64 by a knot being tied in the cord around the eyelet ring 64 and the knot being secured b a medical grade glue.

[0039] Details of the construction of the second tissue connector 14 are shown in Figs. 9, 10, 11 and 12. [0040] The second tissue connector 14 is also basically comprised of a base 68 and a hook 72 projecting from the base. The base 68 has a side surface 74 that extends completely around the base. The in embodiment shown in the drawing figures the side surface 74 is cyiindrical and has a center axis 78 that defines muiuaiiy perpendicular axiai and radial directions relative to the base 88. The base 68 also has a proximal end surface 78 at one axial end of the base and a distal end surface 80 at the opposite axiai end of the base.

[0041] The base proximal end surfac 78 is chamfered or tapers as it extends axialiy away from the cyiindrical side surface 74. In the embodiment of the second tissue connector 88 shown, the base proximal end surface 78 has a conicai configuration with a circular peripheral edge 82 defined by the intersection of the proximal end surface 78 with the cylindrical base side surface 74. The proximal end surface 78 tapers as it extends from the cylindrical side surface 74 to an apex 84 on the proximal end surface. A hole 86 passes through the center of the apex 84 of the proximal end surface 78 to an interior bore of the base that is described later.

[00423 The base distal end surface 80 is substantially flat. The distal end surface 80 has a circular peripheral edge 88 defined by the intersection of the distal end surface 80 and the cylindrical base side surface 74,

[0043] A ook hole 92 is formed in the base distal end surface 80. The hook hoie 92 is spaced radially inwardly from the distai end surface peripheral edge 88 and radially from the center axis 78. The hook hole 92 extends axially into the base a short distance from the distal end surface 80 and does not extend entirely through the base. [0044] The hook 72 of the second tissue connector 14 has substantially the same construction as the hook 22 of the first tissue connector 12. The hook 72 has a straight shank portion 94 extending from a proximal end 98 of the hook. Adjacent the proximal end 96 the hook shank portion has a cylindncai configuration dimensioned to fit iightiy into the hook hole 88 on the distal end surface 80. The hook shank portion 9 is secured to the base distal end surface 80 by laser welding or other equivalent means. The hook shank portion 94 extends axialiy from the base distal end surface 80 substantially parallel with the base center axis 76 but spaced radially from the center axis. The shank portion 94 extending from the distal end surface 80 has a square or other similar cross-section configuration that facilitates grasping the shank portion with surgical graspers and preventing rotation of the shank portion in the graspers. The hook shank portion 94 extends axialiy from the base to a bent portion 98 of the hook that extends radially over the base distal end surface 80 and through the base center axis 76. The hook bent portion 98 extends from the shank portion 94 to a dsstal end tip 100 of the hook. The hook distal end tip 100 and shank portion 94 are both spaced a radial distance dimension on opposite sides of the center axis 76 that is smaller than the base radius dimension, whereby the hook bent portion and the distal end tip 100 do not project radially beyond the cylindrical side surface 74 of the base. Although the hook 72 is shown as the part of the tissue connector that is removably attachable to body tissue, other equivalent devices that do not project radially beyond the side surface of the base could be used. Additionally, although both tissue connectors 12, 14 are described as having chamfered or tapered surfaces 28, 78, it is not necessary that both have tapered surfaces for the intended functioning of the apparatus. [0046] Although the first 12 and second 14 tissue connectors have similar constructions as discussed above, the second tissue connector 14 is constructed with a releasabie one-way cord lock that enables the length of the portion of the cord 6 extending between the two tissue connectors 12, 14 to be adjusted.

[0046] The second tissue connector base 68 has a tubular confsguraiion with a cylindrical housing wail having the base cylindrical side surface 74 on its exterior, and a ho!!ow interior bore 102 extending through the length of the housing wall interior.

[0047] A disk shaped cap 104 is secured to a distai end of the base housing wall by iaser welding or other equivalent means. The disk-shaped cap 104 defines the distal end surface 80 of the base.

[00483 A rod or 'n 106 is secured to the base 88 in the base interior bore 102. The rod 106 extends radially across the base interior bore 102 adjacent the proximal end surface 78 of the base. Opposite ends of the rod 108 are secured to the interior surface of the base cylindrical housing,

[0049] The cord 18 is secured to the second tissue connector 14 inside the base interior bore 102. The second end 56 of^" the cord 16 extends through the center hole 86 in the apex of the base proximal end surface 78 and into the ho!iow interior bore 102 of the base. An intermediate portion of the cord 112 is wrapped around the rod 106 in the base interior, thereby attaching the cord 16 to the second tissue connector 14. The intermediate portion of the cord 1 2 is wrapped around the rod 106 by being tied in a knot around the rod. The preferred knot 112 is a Munter hitch knot. A first portion 114 of the cord length extends from the intermediate portion 112 though the base center hole 86. The cord first portion 1 4 extends from the proximal end surface 78 of the base to the cord first end 54 attached to the first tissue connector 2, A second portion of the cord length 1 18 extends from the cord intermediate portion 1 12 throug a side hole 118 in the base cylindrical side surface 74 and the proximal end surface 78. The side hole 1 8 is provided to separate the cord first portion 1 14 and the cord second portion 116 to prevent tangling. The side hole 1 18 also allows for a greater angle that the cord second portion 116 can be pulled from the connector. The second portion of the cord 116 extends from second tissue connector 14 to a second, free end 122 of a cord. OOSOj The releasab!e one-way cord lock is comprised of a pair slots 124 that are formed in radially opposite sides of the cylindrical side wall of the base 68. As seen in the drawing figures, the slots 124 extend axiaily along a portion of the cylindrical wait of the base 68 and are positioned radially to one side of the base center axis 76. A lock pin 126 is positioned in the slots 124 and extends from one slot 124 across the interior bore of the base 68 to the other slot. The Sock pin 126 slides axial ly along the slots 124.

[0051] An actuator 128 is mounted on the base cylindrical side surface 74 and is connected to the lock pin 126 inside the base. The actuator 128 is formed as cylindrical sleeve that surrounds the base cylindrical side surface 74. The actuator 128 is mounted on the cylindrical side surface 74 of the base 68 for axialiy reciprocating movements between first and second positions of the actuator 128 relative to the base 68. The opposite ends of the lock pin 126 project beyond the slots 124 in the base cylindrical side surface 74 and are secured in opposite sides of the actuator 128. Moving the actuator 128 to its first position shown in Fig. 1 1 causes the lock pin 126 to engage against the cord intermediate portion 112 that is wrapped around the rod 106. in Fig. 1 1 , the pin 126 prevents the knot 1 12 from rotating counterclockwise around the rod 106 when the knot 112 is in a 3 o'clock position, or to the right of the rod as shown in Fig, 11 and the cord first portion 114 is pulled. The engagement of the lock pin 126 against the cord intermediate portion or knot 1 2 locks the cord and prevents the first portion of the cord length 114 from being pulled from the proximal end surface 78 of the second tissue connector 14. However, in the position of the knot 112 shown in Fig. 1 1 the cord second portion 1 16 can be pulled from the second tissue connector 14 to shorten the length of the cord first portion 1 14, but the cord first portion 114 cannot be pulled from the connector. Moving the actuator 128 to its second position causes the lock pin 26 to disengage from the cord intermediate portion or knot 112. With the pin 126 moved upward, the cord first portion 1 14 can be pulled to move the knot 12 counterclockwise from the 3 o'clock position to a 6 o'clock position as viewed in Fig. 1 1 . This allows the length of the cord first portion 11 extending between the second tissue connector 14 and the first tissue connector 12 to be pulled from the second tissue connector 14 to adjust or increase the length of the cord first portion 114. With the pin 126 moved upward the cord second portion 116 can also be pulled from the connector. [0052] A biasing device 132 urges the lock pin 126 to its first position shown in Fig. 1 . !n the drawing figures the biasing device 132 is a coiled spring. Other equivalent types of biasing devices could be employed.

[00533 The slot 124 and the pin 126 are off center relative to the base cylindrical side surface 74 to facilitate the knot 1 12 pushing the pirt 126 upward against the bias of the spring 132 when the cord second portion 16 is pulled and the knot 112 moves clockwise from the 6 o'clock position to the 3 o'clock position relative to the rod 106,

[00543 Tissue connectors having one way cord locks such as that described above are disclosed in the currently pending international patent application No. PCT/US2011/01494, which is assigned to the assignee of this invention and is incorporated herein by reference,

[00553 Fig. 2a shows a further embodiment of the apparatus of the invention comprising the first tissue connector 12 and the second tissue connector 14 connected by the length of cord 16, However, the first end of the Iength of cord 16 is connected to the first tissue connector 12 having the eyelet ring 64 that was described earlier. In addition, a second length of cord 134 connects a third tissue connector 136 to the first tissue connector 12, The construction of the third tissue connector 136 is substantially the same as that of the second tissue connector 14 described earlier. In the embodiment of Fig. 2A, at least two of the three tissue connectors would require tapered proximal end surfaces in order for the apparatus to function as intending in removing the apparatus from a surgical site as described below. [0056] Fig. 2B shows a still further embodiment of the apparatus where the tissue connector hook 72 or other equivalent device is not directly connected to the base 68 of the second tissue connector 14, but is connected by a further length of suture 138.

[00573 The apparatus of the invention also comprises a tissue connector deliver and removal tube 142 shown in Figs. 13 and 14, and a delivery rod 144 shown in Fig. 15.

[00583 !n one embodiment of the apparatus, the tube 142 has a straight length with opposite proximal 146 and distal 148 ends. An interior bore having a smooth cylindrical interior surface 152 extends through the length of the tube. The cylindrical interior surface 52 has an interior diameter dimension that is just slightly larger than the exterior diameter dimension of the first tissue connector base cylindrical side surface 24 and the second tissue connector base cylindrical side surface 74. This enables the issue connectors 12, 14 to easily slide through the interior bore of the tube when delivering the tissue connectors through the tube, or removing the tissue connectors through the tube.

[0050] The delivery rod 144 has a straight length that is dimensioned to be inserted into the tube proximal end 148 to push the tissue connectors 12, 14 and the connecting cord 16 through the tube interior bore to deliver the tissue connectors and the connecting cord from the tube distal end 142 and to a surgical site in a body,

[0060] Additionally, the tapered configuration of the base proximal end surface 28 of the first tissue connector 12 and the tapered configuration of the base proximai end surface 78 of the second tissue connector 14 enables the tissue connectors to be easiiy pulled into the interior bore of the tube 42 at the tube distal end 148. However, it is only necessary that one tissue connector 12 have a tapered proximal end surface in a two connector embodiment of the apparatus such as that shown in Figs. 1A and 1 B. When it is desired to remove the tissue connectors 12, 14 from a surgical site in an area of the body, the tube distal end 142 is positioned in the area by inserting the distai end through a cannula or through an incision to position the tube distal end 148 at the surgical site. An instrument, for example a surgical grasper is then inserted through the tube 142 unti! it emerges from the tube distai end 148. The surgical grasper then grasps the second tissue connector 14 at the hook 72. The surgical grasper is then removed through the tube 142 moving the second connector 14 hook first into the tube distai end and pulling the cord into the tube distai end 142. The cord 16 is then continued to be pulled through the tube unti! the tapered configuration of the base proxima! end surface 28 of the first tissue connector 12 is pu!ied into the tube distai end 148. The tapered configuration of the proximal end surface 28 centers the base cylindrical side surface 24 of the first tissue connector 12 relative the tube interior bore as the tapered proximal end surface is pulled into the tube interior bore. With the base cylindrical side surface 24 centered in the interior bore of the tube 142, the hook 22 projecting from the base distal end surface 30 is prevented from snagging or catching the distal end 148 of the tube 42 as the first tissue connector is pulled into an through the tube.

[0061] Thus, as described above, the apparatus of the invention and its method of use facilitate the delivery of surgical tissue connectors to a laparoscopic surgical site and facilitate the removal of the surgical connectors from the surgical site. [0062] As various modifications couid be made in the apparatus herein described and illustrated and its method of use without departing from the scope of the invention, it is intended that al! the matter contained in the foregoing description or shown in the accompanying drawings shall be interpreted as iiiustrative rather than limiting. Thus, the breath and scope of the present invention should not be limited by any of the above described exemplary embodiments, but should be defined oniy in accordance with the following claims appended hereto and their equivalents.

Claims

1. A tissue connector apparatus comprising: at iease one tissue connector having a base with a cylindrical side surface, the cylindrical side surface having a center axis thai defines mutually perpendicular axial and radial directions relative to the base, the base having a radius dimension between the center axis and the side surface, the base having a proximal end surface and a distal end surface at axiaily opposite ends of the base side surface; the base proximal end surface having a tapered configuration that tapers as the proximal end surface extends axiaily away from the base cylindricai side surface; and a length of cord connected to and extending from the base proximal end surface.

2. The apparatus of Claim 1 , further comprising: a tissue connector delivery and removal tube, the tube having an interior bore with an interior diameter dimension that is larger than a diameter dimension of the base cylindrical side surface.

3, The apparatus of Claim 1 , further comprising: the base proxima! end surface having a conical configuration.

4, The apparatus of Claim 1 , further comprising; the length of cord extending from the base proximal end surface being adjustable in length.

5. The apparatus of Claim 1 , further comprising: a hook secured to the distal end surface of the base.

8. The apparatus of Claim 1 , further comprising: a hook secured to the base, the hook having a shank portion that extends axially from the base distal end surface, the shank portion being parallel with and radiaily spaced from the center axis, the hook having a bent portion that extends from the shank portion across the center axis to an end tip of the hook, the hook end tip and the hook shank portion each being radiaily spaced on opposite sides of the center axis by radiai distance dimensions that are smalier than the base radius dimension,

7. The apparatus of Claim 6, further comprising: the base distal end surface having a circular peripheral edge that is coaxial with the center axis; and the hook bent portion and the hook end tip do not extend radially beyond the distal end surface peripheral edge.

8, A tissue connector apparatus comprising: at least one tissue connector having a base with a cylindrical side surface, the cylindrical side surface having a center axis that defines mutually perpendicular axial and radial directions relative to the base, the base having a proximal end surface and a distal end surface at axiaSly opposite ends of the base side surface; the base proximal end surface having a tapered configuration that tapers as the proximal end surface extends axia!iy away from the base side surface; and a length of cord connected to and extending from the base proximal end surface.

9. The apparatus of Claim 8, further comprising: a connector delivery and removal tube having an interior diameter dimension that is larger than a diameter dimension of a base cylindrical side surface,

10. The apparatus of Claim 8, further comprising: the base proximal end surface having a conical configuration.

11. The apparatus of Claim 8, further comprising: th length of cord extending from the base proximal end surface being adjustable in length.

12. The apparatus of Claim 8, further comprising: a hook secured to the base distal end surface.

13. The apparatus of Claim 8, further comprising: a hook secured to the base, the hook having a shank portion that extends axiaily from the base distai end surface and the hook having a bent portion that extends from the shank portion radially across the distal end surface to an end tip of the hook, where the hook bent portion and the hook end tip do not project radially beyond the cylindrical side surface of the base.

14. The apparatus of Claim 13, further comprising: the base distal end surface having a circular peripheral edge that is coaxial with the base center axis; and the hook bent portion and the hook end tip do not extend radially beyond the distai end surface peripheral edge,

15. A tissue connector apparatus comprising: at least one tissue connector having a base with a side surface extending around the base and a proximal end surface and a distal end surface at opposite ends of the side surface, the proximal end surface having a tapered configuration that tapers as the proximal end surface extends away from the base side surface; and a hook secured to the base distal end surface. 18. The apparatus of Claim 15, further comprising: a cord extending from the base proximal end surface. 17, The apparatus of Claim 15, further comprising: the base proximal end surface having a conicai configuration.

18, The apparatus of Claim 15, further comprising; a connector delivery and removal tube having an interior bore dimensioned to receive the base side surface through the interior bore.

19. The apparatus of Ciaim 16, further comprising: a second tissue connector; th cord extending from the base proximai end surface to the second tissue connector, and the cord having an adjustabie length between the base proximai end surface and the second tissue connector.

20, The apparatus of Ciaim 15, further comprising: the hook being secured to the base distal end surface by a iength of cord.